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Disturbed microvascular function precedes clinically apparent microvascular complications. Complications are not confined to the eye and the kidney; they occur in many tissues, e.g. the heart and brain. Microvascular complications are the result of the combined effects of hyperglycaemia and haemodynamic factors on cells, modulated by genetic predisposition (Fig. 13.5.1.1). The intracellular pathway involved varies with the stage (i.e. whether in the initiation or progressive phase) and organ (kidney, eye), and may be modified by treatment. This chapter describes the generic factors involved...

Disturbed microvascular function precedes clinically apparent microvascular complications. Complications are not confined to the eye and the kidney; they occur in many tissues, e.g. the heart and brain. Microvascular complications are the result of the combined effects of hyperglycaemia and haemodynamic factors on cells, modulated by genetic predisposition (Fig. 13.5.1.1). The intracellular pathway involved varies with the stage (i.e. whether in the initiation or progressive phase) and organ (kidney, eye), and may be modified by treatment. This chapter describes the generic factors involved in the pathogenesis of microvascular complications. Further details are available in recent reviews (1–10).